Case Report: Aberrant Left Vertebral Artery Management in Traumatic Transection of the Aortic Isthmus

Authors

  • Ovidiu Stiru Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Liana Valeanu Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Catalina Andreea Parasca
  • Roxana Carmen Geana Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Platon Pavel Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Marian Croitoru Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Diana Tudor Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Serban Bubenek Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Vlad Anton Iliescu Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania

DOI:

https://doi.org/10.1532/hsf.2677

Keywords:

Aortic arch pseudoaneurysm, TEVAR, Aberrant left vertebral artery

Abstract

Association of elective debranching and endovascular thoracic aortic repair (TEVAR) with aberrant left vertebral artery (AVA) revascularization and supra-aortic left carotid-subclavian bypass in post-traumatic pseudoaneurysm of the distal aortic arch are extremely rare procedures that can minimize unnecessary neurologic complications.

The patient was a 42-year-old man, stable, with a post-traumatic transection of the aortic isthmus, with origin of the AVA between the left common carotid artery (LCCA) and left subclavian artery (LSA). Preoperative planning and proper sizing of the stent-grafts were evaluated by means of computed tomography angiography (CT scan) images. The patient underwent a hybrid procedure that included TEVAR with landing zone 2, covering the origin of both the AVA and LSA and concomitant supra-aortic reimplantation of the AVA in the LCCA and left carotid-subclavian bypass combined with both ligation of the AVA and LSA proximally. Postoperative arteriography images confirmed the exclusion of the aneurysm and the patency of all arch vessels, including the AVA. No endoleak was reported.

Author Biographies

Ovidiu Stiru, Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania



Catalina Andreea Parasca

Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Bucharest, Romania, MD, Department of Cardiovascular Surgery
“Carol Davila” University of Medicine and Pharmacy, Bucharest, Assistant Professor of Cardiovascular Surgery

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Published

2019-12-17

How to Cite

Stiru, O., Valeanu, L., Parasca, C. A., Geana, R. C., Pavel, P., Croitoru, M., Tudor, D., Bubenek, S., & Iliescu, V. A. (2019). Case Report: Aberrant Left Vertebral Artery Management in Traumatic Transection of the Aortic Isthmus. The Heart Surgery Forum, 22(6), E481-E485. https://doi.org/10.1532/hsf.2677

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